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Adequate selenium intake is mandatory for the normal function of thyrocytes, and selenium deficiency is associated with the decreased synthesis of thyroid hormones (191), increased thyroid volume, and increased number of thyroid nodules (182, 192)

Performance Return Clinical observations indicate elevated growth hormone and IGF-1 levels without significant cortisol or prolactin disruption

To advance the clinical utility and equity of VR interventions, future trials should prioritize ecological designs that assess usability and engagement in home-based or minimally supervised settings

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